• Cottage Health (Goleta, CA)
    …seeks a Utilization Review Manager, Registered Nurse for their Clinical Denials and Appeals department responsible for the overall management of ... and staff. The manager actively manages, maintains and communicates clinical denials and appeals activity to appropriate...Preferred: 2 years direct patient care experience as an RN in an acute care setting. About Us Cottage… more
    Upward (07/23/25)
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  • NavitsPartners (Hyannis, MA)
    Job Title: Travel Case Manager - LPN/ RN (Emergency Department) Location: Hyannis, MA 02601 Duration: 13 Weeks Shift: 11:00 AM - 9:30 PM or 11:30 AM - 10:00 PM Type: ... Hyannis, MA is seeking an experienced Travel Emergency Department Case Manager (LPN or RN ) for a 13-week travel assignment. The Case Manager will play a vital role… more
    Upward (07/23/25)
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  • NewYork-Presbyterian Hospital (Brooklyn, NY)
    …an average of 60-70 medical/surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 ... (United States of America) Description: Discover Where Amazing Works Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located in Park Slope, Brooklyn,… more
    Upward (06/29/25)
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  • Franciscan Missionaries of Our Lady Health System (Baton Rouge, LA)
    …criteria for patients in a specific department. The Case Manager of Clinical Services specializes in the review of information pertaining specifically to the ... for assessing an individual's level of physical/mental impairment. Assesses patient clinical information and in collaboration with the healthcare team, develops… more
    Upward (07/20/25)
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  • Public Health Trust of Dade Co (Miami, FL)
    Clinical Transplant Coordinator, Heart Acquisition, Full Time, Days Department: Miami Transplant Institute (Heart Acquisition) Address: 1801 NW 9th Avenue, Miami, ... highly regarded multidisciplinary team of healthcare professionals. Position Summary: The Clinical Transplant Coordinator is a professional designated member of the… more
    Upward (07/23/25)
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  • AHMC Healthcare (Daly City, CA)
    Overview QUALIFICATIONS/JOB REQUIREMENTS: EDUCATION: CERTIFICATIONS/LICENSURE: Current California Registered Nurse License in good standing Current BLS ... in an acute care setting preferred. Working knowledge of current clinical , regulatory, accrediting, and third-party payor standards (ie Medicare, MediCal, and… more
    Upward (07/01/25)
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  • Trinity Health (Darby, PA)
    …time Shift: Evening Shift Description: Under the general supervision of the RN Care Coordination Manager and Director of Care Coordination, the Emergency Department ... patient safety parameters, LOS, readmissions, and risk for denials and appeals . Knows, understands, incorporates and demonstrates the Trinity Health Mission, Vision,… more
    Upward (07/17/25)
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  • Banner Health (Phoenix, AZ)
    Primary City/State: Phoenix, Arizona Department Name: Clinical Decision Making Work Shift: Day Job Category: Physicians The Senior Medical Director, Network ... Performance is a senior clinical executive responsible for advancing the performance of Banner Health's network of employed and contracted providers across Medicare… more
    Upward (07/07/25)
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  • Clinical Management Consultants (Escondido, CA)
    …of Emergency Services focuses on coaching and mentoring employees to uphold clinical excellence, including guiding RN Manager Emergency teams through ongoing ... recognized and award-winning Hospital is actively interviewing for a Nurse Manager to lead the Emergency Services Department. This...of services, many of which have been recognized for clinical excellence, this medical center has earned its strong… more
    Upward (07/06/25)
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  • Clinical Appeals Supervisor

    R1 RCM (Chicago, IL)
    …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (07/18/25)
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